A medical article published by the Journal of Allergy and Clinical Immunology on December 17th, 2010 reported that food allergies are sending more Americans to the Emergency room than before. The researchers estimated that between 2001 and 2005, just over one million visits were made to the ER for a food allergy. Dr.Clark at Children’s Hospital in Boston reported that food-induced allergic reactions have doubled over the six-year period from 2001 to 2007. The U.S. Center for Disease Control and Prevention reported that 3 million school-aged children in the U.S. had a food allergy in 2007; this was up 18% from 10 years earlier. These are staggering numbers considering much of the lay press has been downplaying the significance of food allergies and saying that food allergies are over-diagnosed.
As an NYC allergist, my concern is two-fold: that children and adults be properly evaluated and diagnosed for a true food allergy, and if they do have a food allergy that they are prepared to treat the unexpected emergency situation. The Food Allergy News (a newsletter from The Food Allergy & Anaphylaxis Network) in December 2010 had a lead article on a survey done at the University of Michigan to try and categorize the scope of the problem of food allergies on its undergraduate student population. Specifically, they were most interested in the food allergy preparedness of the student and the campus health facilities. 513 students responded to the survey and 293 reported they had a known food allergy. Almost 48% said they had emergency medication with them in case of a food allergy reaction. However, in most cases (41%) it was Benadryl, not the more powerful and effective self-injectable epinephrine (just 21%).
What’s baffling is that 24% of the students that had a life-threatening allergic reaction (anaphylaxis) had never been prescribed epinephrine. This problem is close to my heart as both a doctor and a parent. My alma mater, Brown University, had a tragedy occur a few years after I attended. A young man with a known peanut allergy had a bowl of chili at a restaurant, not knowing it was made in a peanut base; he went into anaphylaxis and died. I don’t know if he had an injectable epinephrine device, but I do know that studies done at Mount Sinai have shown that patients that use the epinephrine injectable device within minutes have much better outcomes – and a much lower risk of death. I try to teach my patients with severe food allergies to not only carry their EpiPen with them at all times but to know how to use it properly, so they are ready and not afraid if the situation arises.
If someone has a severe allergic reaction, especially if it requires emergency room attention, I believe it is critical to see an allergy specialist to be tested to see which specific food caused the reaction – and to make sure there are no other related foods that may trigger a future reaction. The testing is highly accurate and safe. In my book, Dr. Dean Mitchell’s Allergy and Asthma Solution, I have a whole chapter on this topic and discuss some of the therapies that are being investigated.
Dr. Dean Mitchell
Mitchell Medical Group, NYC & Long Island